不同宫缩药物联合低位B-Lynch缝合术对难治性产后出血的有效性及安全性研究  

Efficacy and safety of different uterine contraction drugs combined with low B-Lynch suture in the treatment of refractory postpartum hemorrhage

作　　者：张丽萍[1] 郭静[1] ZHANG Li-ping;GUO Jing(Department of Obstetrics,Huai an Maternal and Child Health Hospital,Huai an 223002,Jiangsu,China)

机构地区：[1]淮安市妇幼保健院产科,江苏淮安223002

出　　处：《川北医学院学报》2024年第11期1549-1553,共5页Journal of North Sichuan Medical College

基　　金：江苏省淮安市科技计划项目(HAB202129)。

摘　　要：目的:探究不同宫缩药物联合低位B-Lynch缝合术对难治性产后出血的有效性及安全性。方法:纳入135例分娩发生难治性产后出血的孕妇为研究对象,将行卡贝缩宫素联合低位B-Lynch缝合术治疗者为A组(n=45);行卡前列素氨丁三醇联合低位B-Lynch缝合术治疗者为B组(n=45);实施麦角新碱联合低位B-Lynch缝合术治疗者为C组(n=45)。比较各组患者手术时间、术中出血量、术后24 h出血量、血红蛋白(Hb)浓度、血小板计数(PLT)水平、住院时间、凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]水平、性激素[雌二醇(E_(2))、促黄体生成素(LH)、促卵泡激素(FSH)]水平及不良情况发生率。结果:各组患者手术时间、术中出血量、术后24 h出血量、Hb浓度、PLT水平及住院时间比较,差异均无统计学意义(P>0.05);术后24 h,各组患者PT、APTT、TT水平均较术前改善(P<0.05);但各组患者间PT、APTT、TT水平比较,差异均无统计学意义(P>0.05);术后6周,各组患者血清E_(2)、LH、FSH水平均较术前改善(P<0.05);但各组患者间血清E_(2)、LH、FSH水平比较,差异均无统计学意义(P>0.05)。各组患者不良情况发生率分别为13.33%、17.78%、11.11%,组间比较均无统计学差异(P>0.05)。结论:卡贝缩宫素、卡前列素氨丁三醇、麦角新碱联合低位B-Lynch缝合术均可有效治疗难治性产后出血,安全性可,且效果相当,临床中可结合患者实际情况针对性选择治疗方案。Objective:To investigate the effectiveness and safety of various uterine medications in combination with the low B-Lynch suture technique for managing refractory postpartum hemorrhage.Methods:Childbirth in intractable postpartum hemorrhage in 135 cases of pregnant women were analyzed and divided into three groups.Group A was treated with carbetocin combined with low B-Lynch suture,group B was treated with carboprost tromethamine injection combined with low B-Lynch suture,and group C was treated with ergosine combined with low B-Lynch suture,45 cases in each group.The surgical duration,intraoperative blood loss,24-hour postoperative bleeding volume,24-hour postoperative hemoglobin(Hb)concentration,platelet count(PLT)level,length of hospital stay,coagulation function indicators[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)],sex hormone levels[estradiol(E_(2)),luteinizing hormone(LH),follicle-stimulating hormone(FSH)],and incidence of adverse events were compared between the groups.Results:There were no significant differences in operation time,intraoperative blood loss,blood loss within 24 hours after operation,Hb concentration and PLT level within 24 hours after operation,and hospitalization time among the three groups(P>0.05).At 24 hours after the operation,the PT,APTT,and TT levels of the three groups were significantly improved(P<0.05).24 h after surgery,in patients with three groups of PT,APTT,and TT level comparison,there was no statistically significant difference(P>0.05).6 weeks after the operation,the serum E_(2),LH,and FSH levels of the three groups were improved compared with those before the operation(P<0.05),there were no significant differences in serum E_(2),LH,and FSH levels among the three groups(P>0.05).The incidence of three groups of patients with adverse conditions was 13.33%,17.78%,and 11.11%,respectively,there were no statistical significance among the three groups(P>0.05).Conclusion:The combination of carbetocin,carboprost tromethamine injection,and ergot

关 键 词：卡贝缩宫素 卡前列素氨丁三醇 麦角新碱 低位B-Lynch缝合术 难治性产后出血 有效性 安全性 

分 类 号：R714.46[医药卫生—妇产科学]